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MGH Community News |
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MGH Community News |
| February 2022 | Volume 26 • Issue 2 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Hannah Perry, 617-726-8182. Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807. |
State Sending $500 Payments to Half a Million Low-Income Workers
About 500,000 low-income workers across Massachusetts will get a $500 payment from state government in March as the Baker administration rolls out the first premium pay program of its type in the nation, the Executive Office of Administration and Finance announced early this month. The premium pay program was created in the $4 billion COVID-19 relief law that Gov. Charlie Baker signed in December. Residents will be eligible for the payment if their 2020 income from employment was at least $12,750 (the equivalent of working 20 hours a week for 50 weeks at the 2020 minimum wage of $12.75 an hour) and their total income put them below 300% of the federal poverty level ($38,280 for a single filer). A finance official said there will be a state website to help people determine their own eligibility but that most people would find out when they get a check in the mail. No one who received unemployment payments in 2020 will be eligible. Also ineligible are state employees who got a pandemic-related employment bonus from the state. (The Baker administration has inked deals with a number of state employee unions to provide bonuses of up to $2,000 for in-person work during the pandemic.) One of the sections vetoed by Baker would have required that eligibility "include, but not be limited to, essential workers who worked in person and not in a remote setting during the state of emergency declared by the governor on March 10, 2020." An administration official said that the spirit of the vetoed section is preserved because lower-income workers were far more likely to have worked in person early in the pandemic. The first round of payments will disburse a total of about $250 million of the $460 million authorized for the premium pay program. Future rounds will be based on 2021 tax return information and anyone who receives a payment in the first round will not be eligible for payment in a future round, officials said. The state also intends to set up a hot line residents can call with questions about the program.
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FAQs My spouse works part-time, and we file jointly. Are we both eligible to receive a payment? Each spouse must be independently eligible in order for that spouse to receive a payment. In other words, each spouse must 1) be a resident on or after March 10, 2020; 2) have 2020 earnings from employment of at least $12,750; and 2) have no unemployment compensation in 2020. Additionally, you and your spouse’s total income (federal adjusted gross income) cannot be greater than 300% of the federal poverty level ($51,720 for a family of two, or more if you claim other dependents on your taxes). Therefore, it is possible that neither spouse, or only one spouse, or both spouses would be eligible for a payment. I made below the minimum threshold in 2020 but was within the range this past year. Will I be eligible in a future round? Further information on future rounds will be available this summer. Please note that income thresholds may be adjusted for 2021, as both the minimum wage and the Federal Poverty Level figures changed from 2020 to 2021. For more information see the state’s COVID-19 Essential Employee Premium Pay Program website. - Sources
State Seeks OK to Forgive Unemployment Overpayments The Baker administration has asked US Labor Secretary Marty Walsh to intervene and grant Massachusetts permission to forgive wide swaths of overpaid unemployment benefits, warning that state workers will need to process hundreds of thousands of individual applications without federal action. In the latest step to untangle a messy financial thicket of mistakenly overpaid joblessness aid, Labor and Workforce Development Secretary Rosalin Acosta said past “blanket waivers” the federal government issued did “little to alleviate our continuing issues with overpayments in Massachusetts.” Acosta has asked the US Department of Labor to offer another blanket waiver covering all non-fraudulent unemployment benefit overpayments that flowed through four federal programs: Pandemic Unemployment Assistance (PUA), Federal Pandemic Unemployment Compensation (FPUC), Pandemic Emergency Unemployment Compensation (PEUC) and Mixed Earner Unemployment Compensation (MEUC). She said in a letter to Walsh that changes in federal guidance on employment substantiation made partway through the PUA program served as the “primary driver of the overpayment issue in Massachusetts,” leading to more than $1 billion in overpayment determinations for already paid claims. “The Department of Unemployment Assistance (DUA) team continues to work to help claimants apply for waivers or appeal overpayments as permitted by law,” Acosta wrote. “Without a blanket waiver option, however, the agency must evaluate on a case-by-case basis potentially more than 300,000 waiver applications. That process is laborious for the agency and can be frustrating for the claimant. Further, requiring claimants to apply for waivers may present obstacles to underserved communities who were particularly hard hit during the pandemic.” Acosta said that residents who received those federally funded unemployment benefits had already “spent these funds months ago to help preserve their own economic stability,” cautioning that pursuing repayment for improperly high amounts is unlikely to recover much of the funds. - See the full CommonWealth Magazine article.
The Massachusetts Homeowner Assistance Fund (Mass HAF) Outreach Materials Now Available The Massachusetts Homeowner Assistance Fund (Mass HAF) is now fully launched and we encourage you to share information with homeowners in your communities. Mass HAF is a state program that provides mortgage relief - it is a grant not a loan; homeowners do not have to pay it back. Applicants must be at least 3 months behind on their mortgage payments because of the pandemic. As a reminder, ERMA and RAFT are no longer available to homeowners. If you have questions about HAF, please email masshaf@mhp.net. Who is Eligible for Mass HAF? Eligible homeowners:
Homeowners can check if they are eligible by completing a short online pre-screener Applying for Mass HAF To apply, go to massmortgagehelp.org. Applicants will register for an account using an email address. The application is available in multiple languages. Application Help
Outreach Materials Promotional materials about HAF are now available at masshousing.com/HAF. You can find a Mass HAF FAQ flyer (available in Spanish, Portuguese, Vietnamese, Chinese, Russian, Khmer, and Haitian Creole), social media content, FAQs for CBOs and a HAF training. This site will be updated frequently with new materials.
SNAP EBT Online Shopping Extends to Daily Table SNAP participants can now use their EBT cards to make online grocery orders and receive grocery delivery from the Daily Table, a nonprofit food store with locations in Roxbury, Dorchester, and Cambridge. The Boston Mayor’s Office of Food Access (OFA) provided Daily Table with $93,000 using American Rescue Plan funds to support the SNAP online initiative. The Mayor made the announcement while visiting Daily Table’s Roxbury store, interacting with customers and helping to fill online orders. SNAP participants can now use their EBT cards to order groceries online for in-store pickup or delivery via Daily Table’s website or app. This service is ideal for those with mobility challenges, or families who prefer not to shop in-person during the ongoing pandemic. “Our mission is to provide fresh, tasty, and nutritious food to communities most in need,” said Doug Rauch, Daily Table Founder and President. “Over the last two years, the communities we serve have been disproportionately impacted by the COVID pandemic with higher rates of unemployment and skyrocketing food insecurity. SNAP redemption levels in our stores have nearly doubled since the pandemic started. Enabling our customers using SNAP benefits to order free grocery delivery at the same low prices as in our stores democratizes access and empowers customers to get the healthy, affordable food they need and deserve.” Daily Table is one of the first grocery stores in Massachusetts to offer online SNAP benefits, and the only locally-owned, non-profit grocer in the program. All Daily Table customers, including those purchasing groceries with SNAP benefits, who live within a two-mile radius of any Daily Table location are eligible for free delivery. Anyone can shop at Daily Table, but the small business’ focus is on helping end food insecurity. - See the full press release.
Flex Services Fresh Connect Program Reminders This article is adapted from material posted to the MGH Outreach and Resource Navigation listserv. Patients who are members of the MGB ACO and have food insecurity AND one of the following conditions that isn’t improving with traditional healthcare may qualify:
Eligible patients may qualify for medically tailored meals from Community Servings, OR produce and grain boxes from Fresh Food Generation OR a fresh produce debit card from Fresh Connect. A patient can only receive one Nutritional Flexible Service at a time. To Refer
For any further questions, please feel free to reach out to me directly! Advocates may Email Jude Weinstein-Jones with questions. See the Flyer. - Thanks to Kelley Flannery and Jude Weinstein-Jones for sharing this information. Upcoming Changes to MassHealth Nonemergency Wheelchair Van Transport MassHealth is making programmatic changes to how wheelchair van transportation services are provided. Currently, certain wheelchair van transportation for MassHealth members is provided as fee-for-service (FFS) transportation by transportation providers who have contracted directly with MassHealth. This will change effective April 1, 2022, when all wheelchair van services currently covered by MassHealth as FFS transportation will be provided as brokered transportation through Human Service Transportation (HST) Office selective contracts with transportation brokers. Effective April 1, 2022, providers will need to submit a PT-1 request for transportation through the CWP for all wheelchair van transportation. Sedan service will continue to require a PT-1; this is not changing. Authorized Submitters (PT-1) Any MassHealth provider with an active Provider ID (PIDSL) can submit a request to the CWP for wheelchair van or sedan transportation for eligible members needing transportation services to and from MassHealth covered services. Service Delivery Classification The PT-1 form will provide for the following levels of care, depending on the needs of the member. Curb-to-curb PT-1 (traditional) Curb to curb transportation services, with or without attendant/escort (not supplied by transportation provider) via sedan or wheelchair van. Accommodations are limited depending on the member’s ability to ambulate independent of enhanced support. These services can be scheduled through the brokerage upon confirmation of an approved PT-1 (PT-1 Number generated upon eligibility verification through the portal (CWP)). Room-to-room PT-1 (enhanced) Room-to-room transportation services, with or without attendant/escort (not supplied by the transportation provider) via sedan or wheelchair van. Accommodations are enhanced to account for the needs of an individual to be safely transported to/from origin, and destination. These services can be scheduled through the brokerage using their preferred or contracted transportation provider upon confirmation of an approved PT-1 (PT-1 number generated upon eligibility verification through the CWP). Discharge PT-1 (14 day authorization) Limited frequency and duration, intended to safely discharge a member to their destination from an inpatient or outpatient setting. This service can be delivered via traditional or enhanced options dependent on the member’s need or condition at discharge. This service is single use authorization to safely discharge or transition eligible members via traditional or enhanced services. Eligibility MassHealth covers nonemergency transportation to covered medical services for members in MassHealth Standard, CommonHealth, and CarePlus. All other coverage types are subject to existing coverage limitations and criteria for a given plan or program. Ambulance Transportation Emergency and nonemergency ambulance services will remain FFS (non-brokered), and no change will occur to the current process and record keeping requirements. Authorized Transportation Providers/Vendors As of April 1, 2022, a transportation provider must be enrolled with one or both HST transportation brokers in order to be eligible for payment for MassHealth wheelchair van services currently provided FFS. Current brokers are
If a wheelchair van provider is currently providing services as MassHealth FFS transportation, the transportation provider must inform its MassHealth clients that their medical provider (primary care or specialist) will need to submit a PT-1 request on their behalf in order to receive wheelchair van services. Particularly for enhanced room-to-room transportation services, the HST broker will seek to honor existing relationships between transportation providers and provider facilities to the extent possible upon learning of such relationships. For a listing of brokers by town, please see www.mass.gov/doc/find-your-hst-broker/download. -See the full MassHealth All Provider Bulletin 339
Immigration Enforcement- “Protected Areas” Policy Replaces “Sensitive Locations” Policy In 2011 Immigration and Customs Enforcement (ICE) announced a “Sensitive Locations” policy under which supervisory approval would be required for certain immigration enforcement actions. Customs and Border Patrol (CBP) released a similar policy in 2013, but with exceptions for places within “immediate vicinity of the border”. Advocates report inconsistent application of this policy, including arrests near sensitive locations such as outside sensitive locations, including in parking lots. New guidelines, published October 27, 2021, rename these and additional locations “Protected Areas”. The new guidelines unify ICE and CBP policies, strengthen protections and further acknowledge that enforcement actions impact people’s willingness to be in a protected area, and receive or engage in the essential services or activities that occur there. Newly added are “Social Services Establishments” such as a crisis center, domestic violence center, victims services center, supervised visitation center, homeless shelters, drug or alcohol counseling and treatment facilities and food pantries (not a complete list). Also newly added- disaster and emergency response facilities. Protections for health care facilities have been broadened. Instead of only hospitals, now doctor’s offices, health clinic, vaccination and testing sites, urgent care centers, sites that serve pregnant individuals and community health centers are explicitly included. Spaces for children recognized as “Protected Areas” now include playgrounds, recreation centers, childcare centers, before- and after-school care, foster care facility, group home and school bus stops. Faith-Related spaces have been expanded from “churches, synagogues, mosques or other institutions of worship, such as buildings rented for the purposes of religious services” to now include a “place of worship or religious study, whether in a structure dedicated to activities of faith (such as a church or religious school) or a temporary facility or location where such activities are taking place.” In addition to addition spaces being recognized as “Protected Areas”, the guidance includes information about actions near a protected area (though the definition is still somewhat vague). Language includes “We need to consider the fact that an enforcement action taken near – and not necessarily in- the protected area can have the same restraining impact on an individual’s access to the protected area itself.” Factors to consider include proximity, visibility from protected area and whether enforcement action would restrain people from accessing the protected area (not a complete list). There remain however, exceptions and “Exigent Circumstances”, including national security, imminent risk of death, violence or physical harm to any person (but “property was deleted), hot pursuit of someone who poses a public safety threat or personally observed border-crosser, imminent risk of destruction of evidence material to an ongoing criminal case and a safe alternative location does not exist. Absent an exception or exigent circumstances, requires prior approval from agency headquarters. New language includes “To the fullest extent possible, any enforcement action in or near a protected area should be taken in a non-public area, outside of public view, and be otherwise conducted to eliminate or at least minimize the chance that the enforcement action will restrain people from accessing the protected area.” Report Violations Reporting options include:
- Adapted from The Department of Homeland Security’s Protected Areas Policy: What Advocates and Providers Need to Know training, 2/23/22, sponsored by Center for Law and Social Policy, CLINIC and NILC.
New Affordable Connectivity Program Fact Sheet The National Consumer Law Center (NCLC) has created a new Affordable Connectivity Program (ACP) fact sheet. ACP is the permanent program that has replaced the temporary, COVID-19-specific Emergency Broadband Benefit (EBB). Excerpts: What is the Affordable Connectivity Program (ACP)? ACP is a broadband benefit program for low-income households. ACP provides eligible households with a discount of up to $30 a month to lower the cost of broadband service (and up to $75 a month for low-income households on Tribal lands). Some internet providers also offer an ACP discount of up to $100 for a laptop, tablet or desktop computer. Households will have to pay between $10 to $50 towards the computer. What about the Emergency Broadband Benefit? Some of you may be familiar with the earlier emergency broadband discount program, the Emergency Broadband Benefit (EBB). The ACP replaced the EBB on December 31, 2021. While ACP is very similar to EBB, there are some key differences.
Who is eligible for ACP (only need to meet one of the following)?
How to enroll in the ACP (It’s a 2-step process):
If you need help or have questions about the ACP, there is a toll-free ACP Support Center: (877) 384-2575. - See the full Fact Sheet
DTA Memo to Staff- Senior Tax Work Off and Veteran Tax Work Off are Not Income for Benefits Purposes
Certain MA cities and towns offer resident seniors and veterans the option to reduce their real estate taxes by up to $1,500. These programs typically give qualifying seniors/veterans who are at least 60 an opportunity to volunteer hours to a municipal department and in return, receive an abatement from their property taxes. It not only helps participating departments with their work-load but also gives seniors a sense of purpose and well-being in addition to the monetary abatement. In some programs, tf a person is eligible for the program and is physically unable to put the hours in themselves, a volunteer can do the hours on their behalf.
The Department of Transitional Assistance (DTA) this month sent clarification to DTA staff that these programs are considered noncountable income for SNAP, TAFDC and EAEDC. Note that some communities issue W-2s for these programs that add to the confusion. - See the full DTA Online Guide Transmittal, 2022-9., February 17, 2022. Tax Season: What to Know if You Get Social Security or Supplemental Security Income The Child Tax Credit (CTC) is a tax benefit, expanded in March 2021, that helps families who are raising children. You can claim the CTC for any qualifying child even if you don’t usually file a federal tax return. You can get up to $3,600 per qualifying child under age 6, and up to $3,000 for each qualifying child age 6 – 17. These ages are determined as of December 31, 2021. Am I eligible for the CTC if I get Social Security or SSI? Yes, if you meet the qualifying rules of the CTC. You can claim this credit from the Internal Revenue Service (IRS) based on each of your qualifying children, even if you get Social Security or SSI and don’t normally file a tax return. You also may have received up to half of your credit through advance monthly CTC payments made by the IRS from July to December 2021. You will need to file 2021 tax return to get the remainder of the credit. For more information about advance monthly CTC payments, you can visit ChildTaxCredit.gov and the IRS 2021 CTC and Advance CTC Payments Frequently Asked Questions. Will advance monthly CTC payments, or any CTC I claim on my tax return, reduce my Social Security or SSI benefits? Advance monthly CTC payments, as well as any CTC that you claim on your 2021 tax return, won’t reduce your Social Security benefits. If you receive SSI, we won’t count the CTC (or any advance monthly payments you might have received during 2021) as income or resources for 12 months after you receive it when considering your eligibility for SSI and monthly SSI payment amount. If you received any advance monthly CTC payments, be aware of when you received them. You can get that information from the IRS Child Tax Credit Update Portal. The Earned Income Tax CreditWhat is the Earned Income Tax Credit (EITC)? The EITC provides low- to moderate-income workers and families a tax break. If you qualify, you can use the credit to reduce the taxes you owe – and maybe increase your refund. The EITC amount you might get generally depends on your earned income and the number of your qualifying children. Am I eligible for the EITC if I get Social Security or SSI? Yes, if you meet the qualifying rules of the EITC. Receiving Social Security or SSI doesn’t affect your eligibility for the EITC. Do my Social Security Disability Insurance (SSDI) or SSI payments count as earned income for the EITC? Learn if your disability payments count as earned income for the EITC at the IRS’ Disability and the Earned Income Tax Credit webpage. To claim the EITC, you must qualify and file a federal tax return. What if I have questions about the EITC? Learn more about the EITC, including basic qualifications, at the IRS’ Earned Income Tax Credit webpage. Social Security can’t answer EITC questions. - See the full Social Security Administration blog post.
Child Tax Credit Payments Temporarily Shielded from Student Loan Debt Seizure For months, the National Consumer Law Center (NCLC) has been working to shine a spotlight on the deeply harmful government practice of seizing Child Tax Credit (CTC) payments issued through tax refunds to collect on defaulted student loans. In response to a news article we worked on, the Department of Education (ED) has released a statement committing to not seizing the CTC benefits of families with student loans in default this year – even for tax refunds issued after the payment pause ends on May 1. Secretary Cardona then tweeted:
The expanded CTC has been helping millions of families across the country meet children's basic needs – slashing child poverty by nearly 40%. Yet, while Congress protected monthly advance CTC payments last year, families awaiting larger CTC payments through tax refunds this year were at risk of having those payments seized to pay past-due federal student loan debt. Following Secretary Cardona’s announcement, we expect that families with federal student loan debt will be protected from seizure of these CTC payments this year. This decision will have an enormously positive impact for families. Assuming that there are approximately 4 million borrowers with dependent children with defaulted student loans – and that most of these families qualify to receive at least $1,500 in CTC payments in their refund this year — that means roughly $6 billion in CTC funds that may otherwise have been seized will instead go to helping low-income families meet their basic needs and to reducing childhood poverty and hunger. NCLC is urging the Biden Administration to build on this good momentum by committing to make this protection permanent for federal student loan borrowers, and to ensure that no families lose out on the CTC due to struggles with other types of government debt. Student loan advocates and borrowers navigating the complex student loan system, including those with student loan debt collection issues, are encouraged to visit NCLC’s Student Loan Borrower Assistance website for additional information. - Adapted from Victory! Child Tax Credit (CTC) Payments to Be Protected from Seizure, Abby Shafroth, NCLC, Feb 14, 2022.
Massachusetts State House Reopens to The Public The Massachusetts State House has reopened to the public for the first time in nearly two years. The building has been largely closed to all but lawmakers, State House staffers and reporters since the start of the pandemic in Massachusetts in March 2020. Masks are required, as well as proof of COVID-19 vaccination or a negative test from no more than one day before seeking entry. The State House's entry requirements remain in place even as the city of Boston ended its vaccine mandate for indoor spaces the week prior. - See the full WBUR story.
Missing Personal Care Attendant Payments Strain an Already Taxed Workforce On Jan. 1, the state streamlined the way it pays workers who assist people with disabilities, consolidating payroll operations from three providers to one. But the transition hit a major snag, resulting in payment delays for thousands of personal care attendants who count on each paycheck landing in their bank account on time. Deposits resumed within a few weeks, but industry observers say the fiasco has caused some members of an already short-staffed workforce to quit, and may inflict long-term damage on a vital but vulnerable workforce. “We’ve gotten tons of calls from PCAs who are worried about losing their car insurance, being evicted. It’s a real-life crisis for these people,” said Rebecca Gutman, vice president of homecare at 1199SEIU United Healthcare Workers East, which represents the workers. And it could result in a crisis for the profession. PCA pay is currently $17.71 an hour, but is scheduled to drop back to $16.10 when the pandemic premium ends in June. With so many better-paying jobs available, the disruption in pay is driving PCAs to tell the union they may apply elsewhere. “There’s already concern about the availability of PCAs,” she said, “and then something like this happens, and [they] say, ‘I’m going to go look for another job, I can’t afford to do this.’” It’s difficult to know how short staffed the personal care attendant program is, the union said, but industry turnover is high — an estimated 40 to 60 percent of workers quit every year — and the need is growing. Many people who need PCA services are elderly, and the number of adults over the age of 85 is expected to nearly triple between 2016 and 2060. Between 2018 and 2028, more than 1 million home care jobs will be added — the largest growth of any sector in the country, according to PHI, an elder care and disability services advocacy organization. The PCA program, which has a workforce of 55,000, is funded largely through MassHealth, the state’s Medicaid program, and serves more than 40,000 residents who need help with bathing, dressing, and other aspects of daily living. The payment delays occurred because of issues transferring information and operations to Tempus Unlimited, based in Stoughton, according to the state’s Executive Office of Health and Human Services. Previously, Tempus had shared payroll duties with two other “fiscal intermediaries” and was responsible for administering payments to about half of the state’s PCAs. The state said that during the last week of January, it directed Tempus to make payments to about 4,000 attendants who had not been paid since the transition, and that MassHealth would reimburse workers for overdraft and late fees related to the transition. The state has directed Tempus to issue payments multiple times a week to make up for delayed checks, but some people are still waiting on money. The state also hired two contractors to help Tempus with its call center and other operations. The company’s call center was understaffed in part due to COVID-related staff absences, according to the state, which exacerbated the problems caused by the surge in calls. Rachel Abbott, a nursing student at the University of Massachusetts Amherst who started working as a PCA in late December, went without pay until Jan. 20 and didn’t get a paystub until Feb. 1. Without a paystub to verify her income, she couldn’t apply for MassHealth, and she briefly went without health insurance. She spent hours on hold trying to get the problem fixed and her e-mail messages were never returned, she said. She’s thankful her parents were able to help her out but has been questioning if she should continue working in the field. “Tempus is really putting a lot of vulnerable people in a difficult situation,” she said. “It just feels like people don’t see this work as valuable.” - See the full Boston Globe article.
Can I Name a Guardian for My Child in my Will Over the Objections of the Father? I’m due to have a baby in a few months. I’d like to have a legal will in place should something happen to me either during childbirth or after. The child’s father and I are unmarried, though we are together. Unfortunately, there are two individuals in his life who present a safety threat, including a person who used heroin in the presence of my partner’s nieces when they were under the age of 10. How can I make sure that these people don’t get involved in the care of my child if I pass away or become incapacitated? Dear reader, You may be able to give the person you choose to look out for your child more influence through economics. If you have any savings or own your home, you can create a trust to hold such property for your child’s benefit and name a responsible person to manage the trust assets on his or her behalf. This would at least give the trustee the power of the purse strings to make sure your child has a safe and stable home. In terms of creating your estate plan, you can hire an attorney or use a number of online services such as LegalZoom or FreeWill. I don’t know if they include guardian nomination forms in case of incapacity which are more state specific than wills and trusts. - See the full www.AskHarry.info in Marketwatch.com.
Made Up to Code Program Helps Tenants Document Housing Conditions and Advocate with Landlords Greater Boston Legal Services (GBLS) has created a free online program to help educate tenants about their right to live in a safe and decent home. When safety concerns like lead paint or rodents arise for tenants Made Up to Code works to support them by providing information about their rights. Made Up to Code takes users through a five-step process. They first begin by reading about their landlord’s responsibilities. They then are prompted to track the problems in each room(s) of their home. After tracking each problem, they are given the opportunity to add photos and additional detail. At the end they can choose what they want their next steps to be to get the problem resolved with the landlord. Lastly, they can download documents that the program creates which includes a letter to their landlord as well as a problem list with the photos and details that were provided. It typically takes users about 20 minutes to complete all the prompts. The program is available in English, Spanish, Portuguese, and Haitian Creole. Users can also switch languages throughout the program to accommodate both users and advocates. - Thanks to Hannah Perry for contributing this article.
REBUILD Offers Free Therapy for BIPOC Formerly Incarcerated People or “Injustice Involved” People REBUILD was created by a group of organizers to connect people to culturally competent mental health professionals, as it is important that services provided to formerly incarcerated individuals and injustice involved individuals specifically target their individual needs. REBUILD covers the costs of therapy for some individuals (there is a process to apply for up to 10 free sessions), and provides individualized assistance to guide therapy seekers through the process. Lifting up that these services are available to BIPOC formerly incarcerated and/or injustice involved so do share widely among folks you are working with in both the criminal legal system and immigration detention & deportation system. Additional resources translated into multiple languages are forthcoming (know that will help with access). Contact info for REBUILD:
Daily Table Market Set to Open in Mattapan Station this Summer The operators of the Daily Table non-profit grocery market recently announced plans to open two new stores, one in Mattapan and one in Salem. Daily Table already operates a market in the Four Corners/Codman Square area of Dorchester and has another location in Roxbury’s Nubian Square. The Daily Table in Mattapan will be located inside one of the storefronts in the new 100 percent affordable mixed-use development at Mattapan Station. “We plan on opening around July 15,” Celia Grant said at a recent Greater Mattapan Neighborhood Council (GMNC) meeting. The Daily Table is a non-profit community grocery that offers affordable food, produce, and prepared foods. Their model derives about 65 percent of its revenues from sales and about 35 percent of revenues from donations. Recently, they were approved to do online orders for SNAP customers, and any of their online orders come with free delivery to residents living within two miles of the store. - See the full DOTnews.com article.
Medicare Beneficiaries Win Right to Appeal “Observation Status” Reclassifications Last month, the U.S. Court of Appeals for the Second Circuit upheld a ruling that Medicare must provide recourse—appeal rights—to beneficiaries who are admitted to the hospital as “inpatients” and subsequently reclassified as “outpatients” receiving “observation services.” This decision will help people with Medicare pursue coverage for vital post-hospital nursing home care that could otherwise be unaffordable. One of the key consequences of an “observation” designation is the non-coverage of nursing home care. Such coverage is only available if a beneficiary has been hospitalized for at least three days as an inpatient. Patients like Martha Leyanna of Delaware, described in the court’s decision, may thus spend more than three days in the hospital, receiving identical care to that received by patients classified as inpatients, but because their care has been designated as “outpatient” observation services, still lack the three-day “inpatient” hospitalization that is required for nursing home coverage. Ms. Leyanna, who has since passed away, spent her entire savings of $10,000 for nursing home care. Patients may also be forced to forgo required health care altogether because they cannot afford it without Medicare coverage. Yet beneficiaries whose status is changed from inpatient to observation have no opportunity to appeal to Medicare to show that their deprivation of inpatient hospital coverage was wrongful. The trial court had found that this lack of appeals procedures violates the Due Process Clause of the constitution.” The court’s ruling will help many of these clients and allow current and future beneficiaries to take a more active role in building their health and economic security. As a result of the case, those in the nationwide class (patients with traditional Medicare who were switched from inpatient to observation status after January 1, 2009) will be able file appeals for nursing home coverage and reimbursement for out-of-pocket costs, while people currently in the hospital who experience a reclassification will be able to request an expedited appeal. Critically, those who need help in the future will have the legal right to it.
- See the full Medicare Watch article.
Public May be Unaware that Insurance Must Cover Rapid COVID Tests New numbers suggest that so far only a small percentage of Massachusetts residents have taken advantage of a new federal program that requires private insurers to cover the cost of rapid COVID tests. The initiative, announced by the Biden administration at the height of the omicron surge, was intended to address criticism that COVID tests were too costly to use regularly. The program requires private insurers to cover the full cost of eight rapid tests per month for each member. Health insurers were given just five days to set up their programs and required to foot the bill. Many Consumers Still Don't Know Their Insurance Covers Rapid Tests “The most important thing to note is that this is still very early on,” said Lindsey Dawson, a policy analyst at the Kaiser Family Foundation, who has studied the rapid test market and reimbursement programs. Given how new the programs are, it's possible many people aren’t aware they even exist or have not yet looked into their own insurance company’s policy. Robert Carey, a health care consultant and member of the team that launched the Massachusetts Health Connector, said in an email., that it makes sense that people might not know about the programs. “There’s not been much of a marketing and outreach program by insurers [or] the government,” he wrote. - See the full WBUR story.
Medicare Will Cover At-Home COVID Tests at No Cost by Early Spring The Centers for Medicare & Medicaid Services (CMS) has announced plans to make over-the-counter (OTC) COVID-19 tests available to people with Medicare at no cost by “early spring.” According to the agency, “[u]nder the new initiative, Medicare beneficiaries will be able to access up to eight over-the-counter COVID-19 tests per month for free. Tests will be available through eligible pharmacies and other participating entities.” The policy appears designed to help correct the imbalance in the administration’s initial OTC testing policy, which applied to private insurers but not Medicare. As the Kaiser CMS notes the significance of the moment—and the challenges behind it—saying, “[t]his is the first time that Medicare has covered an over-the-counter test at no cost to beneficiaries. There are a number of issues that have made it difficult to cover and pay for over-the-counter COVID-19 tests. However, given the importance of expanding access to testing, CMS has identified a pathway that will expand access to free over-the-counter testing for Medicare beneficiaries.” “Starting in early spring, people with Medicare will be able to go to eligible pharmacies and other entities that are participating in this initiative to receive over-the-counter COVID-19 tests for free through their Medicare Part B coverage. More information about eligible pharmacies and other entities that are participating in this initiative will be available in the early spring. Once the initiative is up and running, CMS will encourage beneficiaries to ask their local pharmacy or current health care provider whether they are participating in this initiative.”
Call 1-800-232-0233 to get help in English, Spanish, and more than 150 other languages. This call-line is open 8 a.m. to midnight ET, 7 days a week. There’s also TTY line (1-888-720-7489) to support access by hearing impaired callers. Read the CMS press release. - See the full Medicare Watch article.
Millions Likely to Lose Medicaid with End of Public Health Emergency The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition. State Medicaid agencies for months have been preparing for the end of a federal mandate that anyone enrolled in Medicaid cannot lose coverage during the pandemic. Before the public health crisis, states regularly reviewed whether people still qualified for the safety-net program, based on their income or perhaps their age or disability status. While those routines have been suspended for the past two years, enrollment climbed to record highs. When the public health emergency ends, state Medicaid officials face a huge job of reevaluating each person's eligibility and connecting with people whose jobs, income, and housing might have been upended in the pandemic. People could lose their coverage if they earn too much or don't provide the information their state needs to verify their income or residency. The U.S. Department of Health and Human Services can extend the public health emergency in 90-day increments; it is currently set to end April 16. Medicaid provides coverage to a vast population, including seniors, the disabled, pregnant women, children, and adults who are not disabled. However, income limits vary by state and eligibility group. For example, in 2021 a single adult without children in Virginia — a state that expanded Medicaid under the Affordable Care Act — had to earn less than $1,482 a month to qualify. In Texas, which has not expanded its program, adults without children don't qualify for Medicaid. State Medicaid agencies often send renewal documents by mail, and in the best of times letters go unreturned or end up at the wrong address. As this tsunami of work approaches, many state and local offices are short-staffed. The Biden administration is giving states a year to go through the process, but officials say financial pressures will push them to go faster. Congress gave states billions of dollars to support the coverage requirement. But the money will dry up soon after the end of the public emergency — and much faster than officials can review the eligibility of millions of people, state Medicaid officials say. Officials and groups who work with people living in poverty worry that many low-income adults and children — typically at higher risk for health problems — will fall through the cracks and become uninsured. Most might qualify for insurance through government programs, the ACA insurance marketplaces, or their employers — but the transition into other coverage isn't automatic. "Even short-term disruptions can really upend a family," said Jessie Mandle, deputy director of Voices for Utah Children, an advocacy group. Independent research published in September by the Urban Institute, a left-leaning think tank based in Washington, D.C., estimated that 15 million people younger than 65 could lose their Medicaid benefits once the public health emergency ends. Nearly all of them would be eligible for other insurance options, including heavily subsidized plans on the ACA marketplaces. Some enrollees could be renewed automatically if states verify they qualify by using data from other sources, such as the Internal Revenue Service and the Supplemental Nutrition Assistance Program. For others, though, the first step entails finding those at risk of losing their coverage so they can enroll in other health benefits. "I am particularly worried about non-English speakers," said Sara Cariano, a policy specialist with the Virginia Poverty Law Center. "Those vulnerable populations I think are at even higher risk of falling out improperly." Meanwhile, states still have no idea when the renewal process will begin. HHS has said that it would give states 60 days' notice before ending the emergency period. The additional Medicaid funds would last until the end of the quarter when the emergency expires — if it ended in April, for example, the money would last until June 30. - See the full NPR story.
Report- Workforce Crisis is Behind Long Mental Health Waits A new report suggests a "workforce crisis" is affecting mental health care in Massachusetts, resulting in longer waits for outpatient treatment and fewer people getting care. The Association for Behavioral Healthcare report released Tuesday said the average wait time in the state for an initial mental health assessment by a licensed clinician is longer than two months. It found that more licensed clinicians are leaving positions than are being hired. The report's findings were based on surveys of 37 agencies that represent 124 outpatient clinic sites across Massachusetts. The clinic sites served almost 93,000 people in the 12 months before the surveys were conducted last October and November. Nearly all the clinics reported increased wait times with almost 14,000 people on wait lists. The average wait for an assessment or therapy for children and youth was three weeks longer than waits for adults, according to the report. The clinics also reported serving 11% fewer people in 2021 than before the coronavirus pandemic began, despite COVID increasing demand for mental health services. "Access to outpatient mental health services continues to diminish," the report said. "Without substantial new investment by private- and public-sectors and the implementation of bold strategies, access will further plummet and cause a system-halting workforce shortage for outpatient and acute mental health services." The factor largely behind the long waits, according to the survey, was a diminishing workforce. The report found that for every 10 master's degree-level mental health clinicians hired, 13 similarly qualified clinicians left their positions in 2021. Nearly half of the outpatient clinics reported it took at least nine months to fill an independently licensed clinician position. The ABH members reported that each clinician served at least 40 people, and many left their jobs because of salaries. "We are concerned that what the data is showing us is that maybe a generation of people has just done the calculus and decided that they don't want to come into this field," said Lydia Conley, president and CEO of the Association for Behavioral Healthcare. Conley said many clinicians are leaving clinics to work in acute hospital settings, where salaries are often higher. The state also increased the number of acute hospital psychiatric beds in response to a dramatic uptick in mental health patients boarding in hospital emergency rooms. But Conley said this contributed to the worker shortage by creating "a potential revolving door" for workers to go to more acute settings, leaving outpatient clinics with fewer resources and staff. The report made several recommendations, including rebalancing health expenditures toward behavioral health and primary care and increasing reimbursement rates and student loan repayment programs for some clinicians. Additionally, the report asked for greater transparency from commercial insurers on reimbursement rates to clinicians and for them to help provide a more complete assessment of the state's mental health workforce. - See the full WBUR story.
Rising SUDs Death Toll and Inaccessible Treatment Programs Drug overdoses now kill more than 100,000 Americans a year, more than vehicle crash and gun deaths combined. Experts have a concise, if crude, way to summarize this: If it’s easier to get high than to get treatment, people who are addicted will get high. The United States has effectively made it easy to get high and hard to get help. No other advanced nation is dealing with a comparable drug crisis. And over the past two years, it has worsened: Annual overdose deaths spiked 50 percent as fentanyl spread in illegal markets, more people turned to drugs during the pandemic, and treatment facilities and other services shut down. In the 1990s, drug companies promoted opioid painkillers as a solution to a problem that remains today: a need for better pain treatment. Purdue Pharma led the charge with OxyContin, claiming it was more effective and less addictive than it was. Doctors bought into the hype, and they started to more loosely prescribe opioids. Some even operated “pill mills,” trading prescriptions for cash. A growing number of people started to misuse the drugs, crushing or dissolving the pills to inhale or inject them. Many shared, stole, and sold opioids more widely. Policymakers and drug companies were slow to react. It wasn’t until 2010 that Purdue introduced a new formulation that made its pills harder to misuse. The Centers for Disease Control and Prevention didn’t publish guidelines calling for tighter prescribing practices until two decades after OxyContin hit the market. In the meantime, the crisis deepened: Opioid users moved on to more potent drugs, namely heroin. Some were seeking a stronger high, while others were cut off from painkillers and looking for a replacement. Traffickers met that demand by flooding the United States with heroin. Then, in the 2010s, they started to transition to fentanyl, mixing it into heroin and other drugs or selling it on its own. Drug cartels can more discreetly produce fentanyl in a lab than heroin derived from large poppy fields. Fentanyl is also more potent than heroin, so traffickers can smuggle less to sell the same high. Because of its potency, fentanyl is also more likely to cause an overdose. Since it began to proliferate in the United States, yearly overdose deaths have more than doubled. A robust treatment system could have mitigated the damage from increasing supplies of painkillers, heroin, and fentanyl. But the United States has never had such a system. Treatment remains inaccessible for many. Many families spend thousands of dollars to try to get loved ones into care. Health insurers often refuse to pay for treatment; legal requirements for insurance coverage are poorly enforced. When treatment is available, it’s often of low quality. Across the country, most facilities don’t offer effective medications; instead, they often focus on unproven approaches, like wilderness or equine therapy. Some are just scams. Beyond treatment, the United States lags behind other countries in approaches like needle exchanges that focus on keeping people alive, ideally until they’re ready to stop using drugs. The country also could do more to prevent drug use and address root causes of addiction, a recent report from Stanford University and The Lancet found. The solutions are costly. A plan that President Biden released on the campaign trail, which experts praised, would total $125 billion over 10 years. That’s far more than Congress has committed to the crisis. Lawmakers haven’t taken up Biden’s plan, and the White House hasn’t pushed for it, so far embracing smaller steps. - See the full Boston Globe article.
Need for Medicare Coverage for Medically Necessary Oral Care Many people with Medicare lack coverage for oral and dental services, despite the clear need for such care. Untreated infections in the mouth have been closely linked to other chronic conditions like rheumatoid arthritis, dementia, stroke, and heart disease.. Access to oral health care is also an equity issue. There are clear racial and ethnic disparities in access to such care, and people with low incomes are especially affected. The lack of comprehensive coverage through Medicare, and the spotty coverage through Medicaid, leaves many older adults and people with disabilities forced to pay out of pocket for dental care, including most forms of medically necessary care. While Medicare Rights continues to advocate for legislation to expand Medicare to include comprehensive dental benefits, we are also working with partners ongoingly to secure coverage of “medically necessary dental” care administratively—an interim step that would complement but not require a legislative fix. Medically necessary dental care is care that treats oral disease that would otherwise likely delay or jeopardize the effectiveness of important and life-saving medical treatments such as organ and stem cell transplantation, heart valve repair or replacement, chemotherapy, and management of autoimmune diseases. While Medicare is not currently permitted to cover most dental care, medically necessary care is, as the term suggests, medically necessary for the effective use of Medicare covered treatments. Therefore, it may be possible for the Centers for Medicare & Medicaid Services to interpret such care as falling outside of the routine dental exclusion. Medicare Rights joined with over 230 other organizations, including medical and dental associations, health care groups, and advocates to explain the need for medically necessary dental coverage in Medicare. The statement draws upon the experiences of experts and advocates who have seen the problems people with Medicare encounter while this coverage gap remains. The goal of this statement is to bring attention to this important need and spur change. -See the full Medicare Watch article.
New Bill Would End Federal Requirement that States Recoup Medicaid Costs from Families On Friday, Representative Jan Schakowsky introduced The Stop Unfair Medicaid Recoveries Act, which would repeal the federal government’s requirement that state Medicaid programs recoup the costs of Medicaid long-term care costs from family members of deceased individuals who received Medicaid for long-term care needs. Estate claims often force heirs to sell a family home that otherwise would have been passed down. Because home ownership is one of the few ways to build generational wealth for lower-income families, the burdens of estate recovery fall disproportionately on economically oppressed families and communities of color. Justice in Aging supports the bill. “By forcing the sale of family homes, Medicaid estate claims keep families in poverty and increase the risk of homelessness,” says Eric Carlson, Directing Attorney, Justice in Aging. The Stop Unfair Medicaid Recoveries Act will fix this problem so that low-income persons don’t have to risk the family home in order to receive needed long-term care.” Read more about the bill and access Justice in Aging’s issue brief. - From New Bill Would End Federal Requirement that States Recoup Medicaid Costs from Families, Justice in Aging, February 15, 2022.
Efforts to End Marriage Penalty for People with Disabilities Momentum is building in Congress to rewrite antiquated laws that strip Americans with disabilities of their federal benefits after marriage. Two bills currently in Congress would end these financial penalties. The laws were written into the Social Security system decades ago. Bethany Lilly, a disability rights advocate, said an overhaul is far past due. “I don't think 50 years ago people would be thinking about people with disabilities getting married, whereas now that's just a perfectly normal, expected part of life for a lot of people,” Lilly said. “But these systems haven't been updated, and so they're still penalizing people.” As senior director of income policy at The Arc of the United States, an organization based in Washington, D.C. that represents people with disabilities, Lilly advises couples to speak with a lawyer before they think about getting married. “That's an unfortunate position to put folks with disabilities into,” she said. She adds it’s also the wrong message to send. The rules around marriage for people who rely on federal disability benefits are complicated. While some couples face a deduction in their monthly payments, others lose benefits and insurance. The Marriage Equality For Disabled Adults Act would ensure that the roughly one million people who are considered disabled adult children wouldn’t lose their federal disability benefits if they got married. Another bill in the Senate would increase the benefit level and end the marriage penalty for people on Supplemental Security Income (SSI), which supports eight million low-income seniors and people with disabilities. Senator Sherrod Brown (D-OH) introduced the legislation last June. Under current law, married couples are docked 25 percent of their SSI benefits. “Supplemental Security Income is a critical lifeline for millions of lower-income older Americans and people with disabilities, but it’s punitive rules have created barriers to getting married and saving for the future,” Warren said in a written statement. - See the full KAZU story. |
